Patient health literacy and the receipt of opioids in the emergency department

Objective: Assess relationships between patient health literacy and formal education and use of opioids during and following an emergency department (ED) visit. Design: Prospective, cross-sectional study. Setting: Academic ED. Participants: Adults aged ≥ 60 years presenting to the ED with musculoskeletal pain. Main outcome measures: Opioid use during and after an ED visit. Results: In a sample of 136 patients, patients with low health literacy were more likely to receive an opioid in the ED than patients with high health literacy (70 percent vs 52 percent; 18 percent difference, 95% confidence interval [CI]: –1 percent, 35 percent), receive an opioid prescription (63 percent vs 44 percent; 19 percent difference, 95% CI: 1 percent, 37 percent), and take opioids during the week following the ED visit (48 percent vs 29 percent; 18 percent difference, 95% CI: 0 percent, 36 percent). Conclusions: A greater proportion of older adults receiving ED care for musculoskeletal pain with low health literacy receive and use opioids during and following an ED visit.